ArticleAnnals of cardiothoracic surgery2015
Quantitation of mitral regurgitation after percutaneous MitraClip repair: comparison of Doppler echocardiography and cardiac magnetic resonance imaging.
Article in Annals of cardiothoracic surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 34 citations in OpenAlex.
- Measuring Atrioventricular Valve Regurgitation Using 4D Flow Cardiovascular Magnetic Resonance Post-Fontan.Pediatric cardiology · 2026Article
- Impact of Left Atrial Ablation on the Atrial Contractile Function: Insights From Intracardiac Echocardiography and Electroanatomical Mapping in Persistent Atrial Fibrillation Ablation.Journal of arrhythmia · 2025Article
- Cardiovascular magnetic resonance imaging in mitral valve disease.European heart journal · 2025Review
- Article
- The Role of Cardiovascular Magnetic Resonance Imaging in the Assessment of Mitral Regurgitation.Diagnostics (Basel, Switzerland) · 2024Review
- The Role of Cardiovascular Magnetic Resonance in Patients with Mitral Regurgitation.Journal of cardiovascular development and disease · 2022Review
- Transcatheter mitral valve repair for primary mitral regurgitation.Reviews in cardiovascular medicine · 2022Review
- Invasive hemodynamics are equivocal for functional outcomes after MitraClip.Health science reports · 2022Article
- Direct measurement of atrioventricular valve regurgitant jets using 4D flow cardiovascular magnetic resonance is accurate and reliable for children with congenital heart disease: a retrospective cohort study.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2020Article
- Initial Slovenian experience with MitraClip therapy : Careful selection of patients is crucial for optimal outcome.Wiener klinische Wochenschrift · 2018Article
- 3D vena contracta area after MitraClip© procedure: precise quantification of residual mitral regurgitation and identification of prognostic information.Cardiovascular ultrasound · 2018Article
- Echocardiographic evaluation and guidance for MitraClip procedure.Cardiovascular diagnosis and therapy · 2017Review
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePercutaneous valve intervention for severe mitral regurgitation (MR) using the MitraClip is a novel technology. Quantitative assessment of residual MR by transthoracic echocardiography (TTE) is challenging, with multiple eccentric jets and artifact from the clips. Cardiovascular magnetic resonance (CMR) is the reference standard for left and right ventricular volumetric assessment. CMR phase-contrast flow imaging has superior reproducibility for quantitation of MR compared to echocardiography. The objective of this study was to establish the feasibility and reproducibility of CMR in quantitating residual MR after MitraClip insertion in a prospective study.
methodsTwenty-five patients underwent successful MitraClip insertion. Nine were excluded due to non-magnetic resonance imaging (MRI) compatible implants or arrhythmia, leaving 16 who underwent a comprehensive CMR examination at 1.5 T (Siemens Aera) with multiplanar steady state free precession (SSFP) cine imaging (cine CMR), and phase-contrast flow acquisitions (flow CMR) at the mitral annulus atrial to the MitraClip, and the proximal aorta. Same-day echocardiography was performed with two-dimensional (2D) visualization and Doppler. CMR and echocardiographic data were independently and blindly analyzed by expert readers. Inter-rater comparison was made by concordance correlation coefficient (CCC) with 95% confidence intervals (CIs), and Bland-Altman (BA) methods.
resultsMean age was 79 years, and mean LVEF was 44%±11% by CMR and 54%±16% by echocardiography. Inter-observer reproducibility of echocardiographic visual categorical grading by expert readers was poor, with a CCC of 0.475 (-0.7, 0.74). Echocardiographic Doppler regurgitant fraction reproducibility was modest (CCC 0.59, 0.15-0.84; BA mean difference -3.7%, -38% to 31%). CMR regurgitant fraction reproducibility was excellent (CCC 0.95, 0.86-0.98; BA mean difference -2.4%, -11.9 to 7.0), with a lower mean difference and narrower limits of agreement compared to echocardiography. Categorical severity grading by CMR using published ranges had good inter-observer agreement (CCC 0.86, 0.62-0.95).
conclusionsCMR performs very well in the quantitation of MR after MitraClip insertion, with excellent reproducibility compared to echocardiographic methods. CMR is a useful technique for the comprehensive evaluation of residual regurgitation in patients after MitraClip. Technical limitations exist for both techniques, and quantitation remains a challenge in some patients.
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